In a village situated at The Nilgiris, five prominent tribal groups, viz,, the Paniyas, Bettakurumbas, Mullukurumbas, Kattunaickens and Irulas, are seen working day and night towards helping the sick feel better and happier.
After centuries of bonded labour and abuse, today, over 75 per cent of the Gudalur's tribal community have dedicated their lives towards improving the health conditions of the people residing in their area.
The project – ASHWINI (Association for Health Welfare of the Nilgiris) celebrated 25 years of its inception.
Looking back at their journey, Dr. Shyla Nandakumar, a gynaecologist and the founder of ASHWINI, which was established in 1990, said that the success of the project was due to the dedication of the tribal community. She also said that the project yielded results due to the manner in which they had pushed themselves from within. The project caters to eight centres around the area, which includes 300 tribal hamlets. ASHWINI also includes community health programmes as well as other training programmes for the community.
The Malayali doctors who made the difference – Shyla and Nandakumar
While Shyla is a Gynaecologist, her husband Nandakumar is a surgeon. The team had trained the tribal community in various areas of health care and hospital administration. But why did they choose to work in such a field? “This was an area where no one wanted to work. There was work happening in the preventive health aspect as well as in the social sector to empower the community,” explained Shyla.
“Most of the major jobs in the tribal hospital at Gudalur are performed by members of the tribal community itself – the nurse, the members of the accounts department and the finance department. Our aim is to get the tribal folk to 'run the show' themselves,” explained Dr Shyla Nandakumar. They were instrumental in setting up the Gudalur Adivasi Hospital.
Dr Shyla had graduated from the Thiruvananthapuram Medical College in the year 1979 while Dr. Nandakumar had completed his MBBS from Christian Medical College, Vellore. Soon after, he went on to pursue his FACS (Fellow, American College of Surgeons) in General Surgical Residency from the New York, Westchester County Medical Centre. In the year 1987, Dr. Shyla went on to pursue her M.D at the institute after a short stint in the USA post the completion of her MD.
Nandakumar, interestingly, wanted to work at place where nobody would consider heading to. While Shyla was pursuing her MD, Nandakumar travelled to different places to understand the needs of the people. A few friends from CMC had told them about a community health programme at Gudalur being run by two doctors named Deva (who is also a Malayali) and Roopa for the tribals living there.
“This suited us as we did not want to have just a hospital, knowing fully well that it would not change the health of the people. We came here in 1990 after I finished my MD and set up ASHWINI as well as the hospital, which complemented the community health work,” said Dr. Shyla Nandakumar.
The Gudalur Adivasi Hospital
The Gudalur Adivasi Hospital was established in the year 1990. The success of the project – ASHWINI is evident from the hospital's progress. The 50-bed hospital generates a turnover of Rs. 20 lakh per month. The community has achieved a lot, especially in terms of infant mortality rate. The current infant mortality rate in the village, according to Dr. Shyla Nandakumar, is approximately 20-30 per thousand as opposed to its previous records of approximately 200-300 per thousand. There are also fewer people dying from diseases such as diarrhoea. A few members of the community also practice traditional medicine and their techniques have worked wonders!
The scenario has changed over 25 years. In the initial stages of the project, the team were rather appalled by the condition of the people in Gudalur. “We thought the tribals in Kerala were better off. But not any more. The tribals in Kerala expect help to come to them. Whereas here, they have learnt to take care of themselves. It is always best to not be charitable in such scenarios for it ruins your self-confidence,” she commented.
Boosting the community's morale
Dr. Shyla Nandakumar said that the project was aimed at empowering the members of the community and to build their self-esteem. “Their work has been tremendous. In fact, these were the people who had gone from pillar to post to seek answers regarding our funding issues from the authorities at the NRHM. The gesture, in itself, was true sense of satisfaction. One shouldn't feel dependent. You health is your problem and you should be able to take care of yourself,” she added.
Overcoming obstacles
It was difficult to raise funds for the cause as well as to get doctors to stay with the team. Moreover, the project involved the participation of several school drop-outs or those who weren't too strong academically. Over a period of time, the group also launched a project called 'Vidyodaya' by academicians such as Ramdas and Rema, which focused on the education of the tribal community.
With the help of the education project, they were able to educate children (including their own) and thus equip them for better medical training.
A deep sense of satisfaction
The project is supported by the Tamil Nadu Government, the Tata Trust as well by many well-wishers. When asked whether she was more satisfied as a gynaecologist, she said, “There is no doubt that the work I do for the tribal community is most satisfying. We are helping them take care of themselves,” she explained.